Featuring Dr. Kam Shojania, MD, FRCPC
Management of Osteoarthritis
Duration: 3 minutes, 15 seconds

Osteoarthritis occurs when the rubbery ends of the bone called cartilage wears away and the bones start to rub together.

That causes three things: pain, stiffness, and inflammation, so we have to manage those three things. So people come in with pain, inflammation, stiffness around a knee. And the management of that would include lifestyle measures, diet, and medications.

For lifestyle measures, the most important thing for osteoarthritis is exercise and balancing the muscles. For example, let's take the knee. We need to strengthen the muscles around the knee to support the knee because the joint is not functioning as well as it should.

So the quadriceps and the hamstring muscles both need to be balanced and strong in order to manage the pain of that knee, and that will help reduce pain and prevent flares of osteoarthritis. We need to help strengthen the knee, but also reduce the force across that weight-bearing joint.

One of the easiest things we can do is lose weight if we are overweight and it's a weight-bearing joint that's painful. So even five or ten pounds of weight loss significantly reduces the strain across a weight-bearing joint, and can improve pain of osteoarthritis as well as reduce the need for joint replacement in the future.

So medications can help improve function and pain with osteoarthritis. The medication can help people exercise. So there are different kinds of medication. There are simple analgesics, such as acetaminophin. Then, to reduce pain and inflammation one can take an anti-inflammatory but those have other potential side effects.

There can be injections into the knee of cortical steroids or treatments that will improve the shock-absorbing potential of the knee and improve the lubrication of the knee. Those are the most significant medical treatments for knee osteoarthritis.

A lot of people try complementary therapies for osteoarthritis, and while people individually may have some benefit there have yet to be good studies to support the use of complementary therapies in managing osteoarthritis of the knee.

Surgery can be recommended in people who have late stage osteoarthritis of a joint. The most common joints that are replaced are the hip and the knee. Other joints can be replaced as well, and people who get knee replacement or hip replacement surgery, the vast majority do extremely well.

However, that is usually the last thing we recommend. Lifestyle measures, exercise, weight loss, medications are the first treatments for osteoarthritis.

If you think you have osteoarthritis, please speak to your healthcare provider to get a diagnosis before going forward.

Presenter: Dr. Kam Shojania, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist